Each space comes with
2 armbands (Kids 12 & under are free with a
paid adult)

Additional armbands are available at $20

Quantity:
Amount: $

Comments

Comments:

Billing, Mailing and Delivery Information:

NAME:

ADDRESS:

CITY: PROVINCE/STATE:

Country: POSTAL CODE:

PHONE (WITH AREA CODE):

EMAIL ADDRESS:

METHOD OF PAYMENT VisaMasterCard

Name of the person on the Credit Card:

Card Number: Expiry Date:

Total Amount to charge to my card

Tickets for the 2012 Challenger may only be purchased in Ontario

This is a secure page

Must be over 18 years of age, vehicle & participant must be present to win.
Winner is responsible for pick up of prize in New Hamburg, Ontario. Liability:
Neither the Producer, the Sponsors nor any Official or Shareholder thereof, or
the owner of the premises at which the show is produced shall be responsible
or liable for any loss or injury to all or any part of the vehicle or
participant or vendor and the participant or vendor does herby waive any and
all rights he may have against him or any of them for such loss or damage.

Moparfest and O.C.C. Auto Club Inc. is an authorized user of these Daimler/Chrysler Corp.
trademarks
Copyright 2012